This study explores the demographic change, implications, and policy challenges in O.R. Tambo district municipality. It seeks to achieve four objectives: (1) to present the current demographic situation of O.R. Tambo and to diagnose demographic issues facing the district; (2) to analyse demographic changes in the district and to assess their various implications for socio-economic development indicators; (3) to propose demographic policy priorities for the district that respond to both demographic challenges and demographic transition; and (4) to ascertain whether O.R. Tambo’s youth bulge will create a demographic dividend? Findings from the analysis of demographic situation in O.R. Tambo district indicate that the district is still at the pre-to-early stage of demographic dividend, as it lags in key human development indicators and has a higher fertility rate.